Provider Demographics
NPI:1255431581
Name:KERWIN, MARIE M (LMSW)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:M
Last Name:KERWIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:M
Other - Last Name:GUSHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2825 LIVERNOIS RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1214
Mailing Address - Country:US
Mailing Address - Phone:248-680-2060
Mailing Address - Fax:248-680-2099
Practice Address - Street 1:2825 LIVERNOIS RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1214
Practice Address - Country:US
Practice Address - Phone:248-680-2060
Practice Address - Fax:248-680-2099
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801065141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical